Press hard. Press fast. Don't stop
Without warning, a family member or
their friend collapses, twitches and gasps a few times, then lies deathly
still. What do you do ?
After calling for help -- exactly the right first move -- most people do
nothing during the agonizing wait for an ambulance to arrive. Starting
cardiopulmonary resuscitation, even if you've never taken a CPR class, can
make the difference between life and death.
Here's all you need to know. Put your hands on the middle of the person's
chest, push hard, and relax. Repeat the push-relax cycle twice a second.
"A bystander who witness someone collapse and who is ready, willing and
able to act doubles or triples that person's chances of surviving," says
Mary Fran Hazinski, lead author of streamlined CPR guidelines from the
American Heart Association.
The guidelines represent a back to basics approach aimed at making CPR
less intimidating and more effective. Previous guidelines were so detailed
that performing CPR not only seemed like a daunting task but was tough to do
properly. A rescuer was supposed to check he airway, give two breaths for
every 15 chest pushes and look for a pulse or heart beat every so often, all
while pressing on the chest 100 times a minutes. Influential studies have
shown that even trained professionals were spending too little time doing
what mattered -- compressing the chest to move blood around the body.
The updated guidelines underscore the importance of maintaining a steady
flow of blood through the heart, brain and other vital organs by emphasizing
chest compressions over everything else. They call for two breaths every 30
compressions and, in some cases, no breaths at all.
Keep in mind that the guidelines are meant to cover virtually all
emergency situations, from drowning and drug overdose to cardiac arrest, for
children and adults. One goal was to set up of recommendations for CPR so
that professional and lay rescuers wouldn't need to learn different
strategies for different situations.
In reality, though, what is needed for someone whose heart suddenly stops
beating (a cardiac arrest) is different from what's needed for someone whose
heart isn't beating due to drowning.
Every day, thousands of people have a sudden cardiac arrest. Their hearts
start beating so wildly that they can no longer pump blood. Most such events
happen at home. Only about 5% of people now survive a cardiac arrest. Wider
use of CPR and faster access to heart-shocking defibrillators could increase
survival rates to 50% or more.
Sudden cardiac arrest sometimes strikes people with seemingly healthy
hearts. Other times it is triggered by the painful slower-developing kind of
heart attack caused by a blocked coronary artery. Either way, it occurs when
the heart's powerful lower chambers, the ventricles veer away from a normal,
steady rhythm and start beating very fast or fast and chaotically.
Surviving a cardiac arrest depends on what has been called the chain of
survival. Quick action is vital.
Call the ambulance. This essential first step summons experienced health
care professionals and their equipment. The dispatcher on the other end of
the line can help you do what needs to be done.
Start CPR. For a sudden cardiac arrest, the most important part of CPR is
pressing on the chest; breathing is secondary. If you start immediately
after someone collapses, you can give up to 50 or 100 compressions between
breaths. Each time you stop to deliver a breath, get back to doing
compressions as fast as you can. If there are two of you doing CPR, have the
larger or stronger one do the chest compressions and the other do the
breathing. Switch when the person doing the compressions starts to tire out.
Restart the heart. CPR by itself wont' transform a lethal heart rhythm
into a regular tick, tick, tick of a healthy heart. That takes a shock from
Advanced life support. The fourth link involves medications and other
techniques such as cooling the body and brain that can improve survival from
a sudden cardiac arrest.